大黄丹皮汤灌肠对创伤后全身炎症反应综合征患者细胞因子和自由基的影响

目的:探讨大黄丹皮汤灌肠对创伤后炎症反应综合征(SIRS)患者细胞因子和自由基的影响。方法:151例符合SIRS诊断的患者随机分为3组,常规治疗组49例、大黄组51例、大黄丹皮汤组51例。于治疗第1、3、7天进行急性生理慢性健康评分系统Ⅱ(APACHE-Ⅱ)评分,检测患者血清肿瘤坏死因子α(TNF-α)、白介素-1β(IL-1β)、白介素-4(IL-4)、白介素-6(IL-6)、白介素-10(IL-10)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、脂质过氧物丙二醛(MDA)和一氧化氮(NO)。结果:各组患者治疗后APACHE-Ⅱ评分均显著下降(P0.05),其中大黄丹皮汤组下降最明显(P0.05)。各组患者治疗后TNF-α、IL-6、IL-10水平均逐渐下降;IL-4水平在治疗第3天明显增高,在第7天出现下降;IL-1β在治疗期间无明显波动。SOD活性和MDA水平治疗后逐渐下降,而GSH-PX活性和NO水平则逐渐升高。对IL-6、MDA、GSH-PX、NO等指标的干预作用大黄丹皮汤组优于大黄组。结论:大黄丹皮汤灌肠治疗能够调控炎性反应系统/抗炎性反应,具有清除自由基和抗脂质过氧化的作用。

Effects of Retention Enema of Dahuang Danpi Decoction on Cytokines and Free Radicals in Patients with Post-traumatic Systemic Inflammatory Response Syndrome

Objective： To investigate the effects of retention enema of ＂Dahuang Danpi Decoction＂on cytokines and free radicals in patients with post-traumatic systemic inflammatory response syndrome（SRIS）Methods： A total of 151 patients with SIRS were randomly divided into three groups as following：49 patients in routine therapy group,51 patients in ＂Dahuang＂group and 51 patients in ＂Dahuang Danpi Decoction＂group.On the lst,3rd and 7th day of treatment,the acute physiology and chronic health evaluation Ⅱ（APACHE-Ⅱ） scoring was performed;tumor necrosis factor a（TNF-a）,interleukinⅠβ（IL-Ⅰβ）,IL4,IL-6,IL-10,superoxide dismutase（SOD）,glutathione peroxidase（GSH-PX）,lipid peroxide malondialchehyche（MDA）and nitric oxide（NO） were determined respectiveiy.Results： APACHE-Ⅱ decreased significantly in both treatment groups（P0.05）,and the decrease in ＂Dahuang Danpi Decoction＂group was more significant of the two（P0.05）.Contents of TNF-a,IL-6 and IL-10 decreased gradually during the therapy period;the content of IL-4 increased on the 3rd day,but then decreased on the 7th day;the level of IL-βdid not change in the treatment period;the activity of SOD and content of MDA decreased,however the activituy of GSH-PX and NO content elevated.The effects of ＂Dahuang＂ group.Conclusion： Retention enema with ＂Dahuang Danpi Decoction＂could modulate the inflammatory and anti-inflammatory reaction,and has the effects of eliminating free radicals and anti-lipid peroxidation.